Abortion in Missouri

I find it more than a little ironic that 39 years after Roe v. Wade made abortion legal in this country, states across the country passed a record-breaking 92 restrictions on access to abortion. Every time I read about another law imposing burdensome requirements on abortion providers or women seeking abortions, I think about a friend of mine who had an abortion in Missouri (my home state and one that has more than its fair share of anti-choice laws). Thankfully, she was able to get the care she needed, but she had to overcome numerous hurdles to do so. And it’s easy to imagine that those obstacles could have been nearly impossible to surmount for another woman whose circumstances were slightly different.

It was about two years ago when Katie called me in tears and told me she was pregnant. She was on birth control but had missed a pill the previous month, which was apparently enough for her to become pregnant. Katie wasn’t ready to have kids, and she was certain that abortion was the right choice for her. But it seemed that the state of Missouri didn’t trust her to make that choice. Over the weeks leading up to her abortion, Katie called me nearly every day, and most days she was in tears. Not only was she going through an emotionally difficult experience, but she was forced to jump through a series of hoops that made her feel as if the state was punishing her for her choice.

Katie’s first challenge was finding an abortion provider. The closest clinic that provided abortion services was 30 miles away (which isn’t surprising, since 97 percent of Missouri counties have no abortion provider), and that clinic only provided abortion services on Fridays, so she had to take time off work for the appointment. This created an additional, unforeseen obstacle. Her employer had frozen all vacation time for that month because of a merger taking place at her company, so in order to take time off work, she was required to submit a doctor’s note confirming the date of her procedure. ON DOCTOR’S OFFICE LETTERHEAD. While I’m lucky to work at an organization where my boss would handle such a matter with discretion and compassion (and where my vacation time would never be frozen, nor would I ever have to provide a doctor’s note to take sick leave, for that matter), Katie was not so fortunate. After receiving the doctor's note on Planned Parenthood letterhead, her boss shunned her for the rest of the time she worked there.

But that’s not all. When Katie called to schedule her appointment, she learned that Missouri has a law requiring women to receive a lecture containing medically inaccurate information from the abortion provider—and then wait 24 hours before receiving services. So she had to drive 30 miles to the clinic twice in one week. One can imagine how difficult this might have been for someone who lives even further from a clinic, doesn’t have a lot of money, or has children to care for.

Missouri law prohibits insurance from covering abortion unless it’s to save the woman’s life. So Katie had to pay nearly $500 out of pocket for the procedure. For a then-24-year old, that’s a lot of money to shell out at a moment’s notice—and I’m sure that for many people, cost alone could be a nearly impossible obstacle to overcome.

Last week, the Washington Post’s Dana Milbank wrote about the anniversary of Roe v. Wade and accused pro-choice women’s groups of spouting unfounded “sky-is-falling warnings about Roe”. He claimed that “Not every compromise means a slippery slope to the back alley.” While Katie didn’t end up in a back alley, she went through a lot to obtain the abortion she needed. And Katie didn't have some of the personal challenges to overcome that could make it even more difficult to access care. If it was that difficult for her, one can imagine what it would be like for someone living even further from a clinic, with less money, and with an even less flexible job. It’s not hard to imagine how such a person might very well end up with no choice but a back alley.